My Blog

Posts for: February, 2017

If you've suddenly noticed your smile looking more “toothy,” you may have a problem with your gums. They may have lost their normal attachment to your tooth and begun to shrink back — or recede.

Millions of people have some form of gum recession. The most common cause is periodontal (gum) disease, but it's not the only one. You may be more susceptible to gum recession because of heredity — you have thin gum tissues passed down to you from your parents. You may also be brushing too hard and too often and have damaged your gums.

Healthy gums play an important role in dental health. The crown, the tooth's visible part, is covered with a hard, protective shell called enamel. As the enamel ends near where the root begins, the gums take over, forming a tight band around the tooth to protect the roots from bacteria and acid.

Receding gums expose these areas of the tooth meant to be covered. This can lead to another tell-tale sign — tooth sensitivity. You begin to notice pain and discomfort while you consume hot or cold foods. And because it leaves your teeth and gums looking much less attractive, it can affect your confidence to smile.

Fortunately, though, we can help restore receded gums. If you have gum disease, it's imperative we treat it as early as possible. We do this by removing plaque, a thin film of bacteria and food particles that triggers the infection. We use special techniques and hand instruments to remove plaque and calculus (hardened plaque deposits) from all tooth surfaces including along the roots.

Gum disease treatment can help stop and even reverse gum recession. In some cases, though, the recession may have advanced too far. If so, we may need to consider surgically grafting donor tissue to the recessed areas. Depending on the site and extent of recession, this can be a very involved procedure requiring microscopic techniques.

The best approach, though, is to take care of your gums now. Daily brushing and flossing removes harmful plaque; regular dental visits take cleaning a step further and also give us an opportunity to detect disease early. By looking out for your gums now you might be able to avoid gum recession in the future.

It's a common question we get from many concerned parents. Their exasperation involves more than having to wake every night to the annoying sounds coming from their child's bedroom: they're also worried about any potential damage occurring to their teeth.

Teeth grinding and similar habits fall under the umbrella term “bruxism.” In basic terms, bruxism is the involuntary movement of the teeth and jaws not engaged in regular functions like chewing, speaking or swallowing. Bruxism is actually common among pre-adolescent children, considered by many healthcare professionals as normal behavior like thumb sucking.

It's not fully known why children grind their teeth, especially during sleep. Stress can play a part, but many believe it could also be related to immaturity on the part of the neuromuscular system that controls chewing. In some cases it could be linked to sudden arousals from sleep, particularly if the child is prone to airway obstruction causing sleep apnea. And there may be a link with certain medications, especially for hyperactivity disorders like attention deficit hyperactivity disorder (ADHD).

Most children eventually outgrow the habit. If it persists, though, it can contribute to teeth problems. Teeth can withstand a lot of biting force, but when chronically exposed to the higher than normal forces produced during teeth grinding they can begin to wear. Sodas, fruit juices, sports drinks or similar acidic beverages complicate matters because they increase mouth acid that can soften enamel. And besides dental issues, teeth grinding can also cause jaw problems, ear pain and headaches.

If symptoms begin to appear, we can take steps to reduce the effect of teeth grinding, such as a mouth guard worn at night to reduce biting forces and protect against wear. We can also look at curbing consumption of acidic foods and beverages, addressing possible airway obstructions, changing medications or counseling for psychological stress.

As with thumb sucking, there's no cause for immediate alarm if your children grind their teeth. But if it continues on into their later childhood years or begins to affect their health and well-being, we'll need to intervene to prevent further harm.

For some time now you've noticed a painful, burning sensation in your mouth for no apparent reason. It doesn't matter what you eat or drink — or whether you eat or drink — the dry, tingling sensation seems to stay with you.

You may have Burning Mouth Syndrome (BMS). You feel as if your mouth is scalded or burning generally or in a certain area like the lips, tongue or inside of the cheeks. Regardless, the discomfort (which seems to grow as the day wears on) can contribute to irritability, anxiety or depression.

It's not always easy to lock in on the specific cause. BMS has been linked, among other things, to diabetes, vitamin deficiencies, or cancer therapy. It's common among women around the age of menopause, so there's some speculation it could be affected by hormonal changes. It could also be connected with dry mouth (brought on by age or medications), an allergic reaction to toothpaste ingredients, acid reflux or autoimmune disorders.

While there's no single proven treatment for BMS, there are some things you can do to lessen its effects. First, stop habits that cause dry mouth like smoking, drinking alcohol or coffee and eating hot and spicy foods. Second, keep your mouth moist by frequently drinking water or using products that stimulate saliva flow.

You might also try toothpastes without sodium lauryl sulfate (a detergent that can cause skin peeling in some people), whiteners or strong flavorings like cinnamon. If you have chronic dry mouth, speak with your physician about any medications you're taking that might be causing it and seek alternatives. And because stress seems to magnify your symptoms, try to reduce it in your life through relaxation techniques, exercise or group support.

In some cases, BMS may resolve itself over time. In the mean time, making these lifestyle changes could help ease your discomfort.

We can easily take for granted the comfort we now experience when we undergo dental work. For much of human history that hasn't been the case.

Local anesthesia has been a major factor in the evolution of pain-free dentistry. The term refers to the numbing of nerve sensation in the tissues involved in a procedure. This type of anesthesia is usually applied in two ways: topical and injectable.

We apply topical anesthetic agents to the top layers of tissue using a cotton swab, adhesive patch or a spray. Topical agents are useful for increasing comfort during cleanings for patients with sensitive teeth or similar superficial procedures. Topical anesthesia is also used in conjunction with injections as a way to prevent feeling the minor prick of the needle. In essence, you shouldn't feel any pain or discomfort from beginning to end of your procedure.

Injectable anesthesia deadens pain at deeper levels of tissue. This makes it possible for us to perform more invasive procedures like tooth extraction or gum surgery without using general anesthesia. The latter form is a more intense undertaking: it renders you unconscious and may require assistance for lung and heart function.

Most important of all, subtracting pain sensation from the procedure helps relieve stress: first for you and ultimately for us. If we know you're comfortable, we can relax and concentrate on the work at hand. The procedure goes much more smoothly and efficiently.

Many people, though, have concerns about how long the numbness will linger after the procedure. This has been viewed in the past as an annoying inconvenience. But in recent years, dentists have become more adept at fine-tuning the agents they use as a way to reduce post-procedure numbness. There's also promising research on chemical agents that can quickly reverse the numbing effect after a procedure.

All in all, though, using local anesthesia broadens the range of dental work we can perform without putting you to sleep. More importantly, you'll be able to relax as we perform procedures that could improve your dental health for years to come.

Drilling teeth is an essential part of repairing and restoring the damage caused by tooth decay. For generations dentists have relied on the dental drill with its rotating burr to remove decayed and damaged tooth material.

But while the dental drill is effective it also has its disadvantages. In the process of removing decayed material it inadvertently removes healthy structure near the target material. It often requires anesthesia to deaden the work area. And its noise and vibration are often unsettling to patients.

There is a growing alternative, though: air abrasion, a technology that's been around since the mid-20th Century. But recent advances in controlling the dust created by using abrasion, as well as new tooth-colored bonding materials to replace tooth structure, have sparked new interest among dentists and patients alike.

Also known as particle abrasion, this drill alternative uses a pressurized stream of fine particles to remove decayed material. Using a hand wand a dentist can precisely aim the stream of particles (usually aluminum oxide) to the specific areas of decay or softened material that need to be removed. As a result, it removes only a fraction of healthy tooth structure compared to traditional drilling. Air abrasion has also proven effective for removing staining without harming enamel.

Air abrasion also eliminates the sound and vibration associated with dental drills, and may not always require local anesthesia. On the other hand, it does have some limitations. For one, it's not as effective with larger cavities or working around older fillings. The tooth or teeth to be worked on must be carefully isolated from the rest of the mouth to keep the patient from swallowing the abrasive particles. And without a high-volume suction pump and good isolation protocols, the particles can produce something of a “sandstorm” in the treatment room.

But as air abrasion continues to advance, we may see improvements in these limitations. In a future time, the traditional dental drill may go the way of the horse and buggy.